Allergen-specific immunotherapy. Hyposensitization

Successful allergen-specific immunotherapy (SIT) induces complex immunologic changes resulting in reduced allergic inflammatory reactions. SIT has long-term effects in mild forms of inhalant allergies and is effective even when standard pharmacotherapy fails. Moreover, the risk to develop additional allergic sensitizations and the development of asthma is significantly reduced in children with allergic rhinitis. SIT is the treatment of choice in patients with systemic reactions to hymenoptera venoms. Although the exact effector mechanisms of SIT still have to be clarified, the most probable effect is a modulation of regulatory T cells associated with a switch of allergen-specific B-cells towards IgG(4) production. The critical point to insure efficacy and safety is the selection of patients and allergens, task best performed by a specialist trained in allergology. Further details are available in the position papers of the German allergy societies - DGAI (Deutsche Gesellschaft fur Allergologie und Klinische Immunologie) and ADA (Arzteverband Deutscher Allergologen) - which can be found at www.dgaki.de.